Dr. Dan Marier clearly remembers his first day of doctoring in Pendleton.
Marier had moved to Oregon from Denver to practice with Dr. Norm Sitz and two other doctors at Pendleton Internal Medicine.
“I started at 8 o’clock on Oct. 15, 1984 — the first day of bird season,” Marier recalls. “There was a note on my desk from Norm that said, ‘Gone bird hunting.’”
Marier saw 20 new patients that day and 20 the next day. He was off and running and didn’t slow down — until recently. The internist retired in December after 33 years in practice.
Marier said he and his then-wife, Cheryl (an obstetrician) selected Pendleton because it satisfied their list of criteria.
“We took vacations and trips all over the western U.S. investigating where to move,” he said. “We chose Pendleton because it was away from a major metropolitan area, it had four seasons and it didn’t have a boom-and-bust economy.”
Turns out, the town needed him.
“They had been recruiting for an internist and had given up,” Marier said.
Marier said he felt at home practicing medicine in the same vein as Marcus Welby, the main character in a long-running television show about an affable family doctor who got involved in his patients’ lives.
“I could develop long-term relationships with my patients,” Marier said. “I could practice the specialty of internal medicine to pretty much its full scope.”
Marier, who is now 68, described himself as a science nerd who grew up in the rustbelt town of Binghamton, New York. As a college student, he studied chemical engineering at Manhattan College, then got accepted to medical school at New York University where tuition cost him $2,400 annually.
He dove into his chosen profession with gusto and good humor. Sitz describes Marier as his highly intelligent and hyperkinetic partner.
“There was never a dull moment,” Sitz said. “I’ll miss having Dan to bounce ideas off of.”
Marier saw plenty of change during his Pendleton career. In early years, access to specialists such as cardiologists was limited unless one drove to Portland, so local physicians performed treadmill tests, echocardiograms and other noninvasive tests. Hospitalists didn’t exist yet, so doctors admitted patients to the hospital and did rounds.
“We’d follow our patients,” he said. “We’d go see patients in the morning before office hours and after office hours and sometimes at noon.”
Marier found certain developments frustrating. One was a federal push in the last decade for doctors to use electronic medical records to track their patients. He found the software clunky, complex, time-consuming and distracting. In the exam room, Marier found himself gazing at the computer screen typing information into a database and missing non-verbal clues from his patients. Finally, both he and Sitz opted to hire scribes so they could concentrate on patients. Eventually, Marier said, “I reverted back to what I was doing 30 years ago. I had a pen, a pad and a dictaphone.”
Another frustration, he said, was doctors’ decreasing clout with insurance companies. In order to have negotiating power, physicians are selling their practices to health care companies. Marier and Sitz did that three years ago when they sold to the Praxis Medical Group.
He also commented on the rising cost of medication such as the price of an EpiPen for allergic attacks, which surged 535 percent from 2007 to 2014. Marier finds this type of spike ethically troublesome.
“The cost of meds has gone through the ceiling — it’s insane,” Marier said. “I think it’s immoral.”
America doesn’t seem destined to return to the days of Marcus Welby anytime soon, though. Marier believes the country needs a single payer system and tort reform to heal our hobbled health care system. Health care, he mused, is unlike any other commodity.
“Market forces don’t apply to medicine the way they do to the auto industry,” Marier said. “When you walk into a dealership and you don’t like the deal, you walk out. When you walk into an ER, you don’t get to say, ‘Well, I’ll think about it overnight.’”
Marier worries about the nation’s worsening shortage of primary care physicians. His partner, already stretched, can’t take on Marier’s patients. It gets worse. Sitz plans to retire soon himself.
“I’m going to retire at the end of June,” Sitz said. “There’s going to be a lot of people trying to find doctors.”
Marier doesn’t miss the irony of he and Sitz having to doctor shop.
“Norm and I wonder who’s going to take care of us,” Marier said.
Marier list of retirement goals includes playing more guitar, singing with the Pendleton Men’s Chorus and traveling with his wife, Connie.
Contact Kathy Aney at firstname.lastname@example.org or 941-966-0810.